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We conducted a study of five patients with congenital diaphragmatic hernia (CDH) in the department of antenatal diagnosis over a period of two years. Our study highlights the overall benchmarks for this disease and its management as well as the news on prenatal assessment of neonatal prognosis using Lung Over Head Ratio (LHR): ultrasound versus magnetic resonance imaging (MRI) in the third world. The purpose of this study is to evaluate the prognosis of these new-born babies and support parents of a fetus with diaphragmatic hernia. [ABSTRACT FROM AUTHOR]

Testimony of a practice by a midwife starting her exercise at the same time as the prenatal diagnosis, the article describes the technical stages and the permanent evolution of a rigorous legislative framework. Hyper-medicalization was imposed exponentially at the same time as the need to face the different emotions and temporalities between teams and couples. The emotional consequences of women and couples forced them to invent adequate relationship support. We had to move forward together, find the right words, give a new place to women and spouses, help professionals so that they can cope with violent emotions, improve transmissions, collect testimonies, invent care models, and finally build adequate training. A collective history has been written over progress and continues: the law, parents, and caregivers. The effectiveness of teamwork, openness to multidisciplinary, the ability to adapt practices on a case-by-case basis, richness of "indirect" work with child psychiatrists, creation of new communication tools to ensure consistency followup are all significant achievements. The path of the prenatal diagnosis, asks the caregivers to remain vigilant and inventive to keep intact the life plans of the parents. The father's place has become obvious and necessary in preventing further difficulties. A recent method of resuming obstetric history, combining medical records and narration by the person concerned, makes it possible to re-mobilize the sequela trauma by resynchronizing concrete data and memory traces in women. [ABSTRACT FROM AUTHOR]

Fetal brain tumors are rare. Teratoma is the most common histological type. Their evolution is often fatal. Ultrasound and magnetic resonance imaging allows for early antenatal diagnosis. However, definitive diagnosis is based on histologic examination. Placental metastases are rare and complicate more often the course of malignant melanomas, hemopathies, breast and bronchial cancers. In pregnant women who have recently had a cancer, anatomopathologic examination of the placenta should be requested to detect tumor invasion. Similarly, neonatal assessment and extended pediatric follow-up are required. The establishment of registries collecting all cancer cases diagnosed among pregnant woman is essential for a better understanding of the epidemiology of these cancers as well as of maternal and paediatric prognostic factors. We here report a case of fetal brain tumor in a woman with recurrent ovarian cancer. [ABSTRACT FROM AUTHOR]

Résumé Les principaux virus responsables d'infections acquises in utero sont le cytomégalovirus (CMV), le virus de la rubéole, le parvovirus B19, le virus de la varicelle et du zona (VZV), et le virus Zika. Au cours de la grossesse, la transmission de certains virus au fœtus et leur retentissement embryo-fœtal est très variable selon l'agent causal et l'âge gestationnel auquel la mère s'est infectée. Les conséquences les plus sévères pour le fœtus sont majoritairement observées au cours des primo-infections maternelles survenues en première moitié de grossesse. Le diagnostic prénatal de ces infections virales congénitales est actuellement possible grâce à des outils biologiques dont la fiabilité est souvent proche de 100 %. L'objectif de cet article est de faire le point sur les outils du diagnostic anténatal et leurs indications. Abstract Viruses that can be transmitted from mother to fetus during pregnancy are mainly rubella virus, cytomegalovirus, varicella zoster virus, parvovirus B19 and Zika virus. Congenital infections may lead to severe damage of the fetus or the newborn depending on the infectious agent and the term of pregnancy where the infection occurred. Symptomatic congenital infections more likely occur in case of maternal primary infection in the first half of pregnancy. Prenatal diagnosis mainly relies on PCR on amniotic fluid, and is usually very reliable. The aim of this article is to describe biological tools available for prenatal diagnosis, and management of congenital viral infections. [ABSTRACT FROM AUTHOR]

Amniotic band syndrome (ABS) comprises of a spectrum of complex congenital malformations mainly interesting the limbs, but even the craniofacial region and the thoracoabdominal axis. There are two major opposing pathophysiological theories: premature rupture of the amniotic sac (exogenous growth theory) would result in the formation of fibrous bands which would lead to strangulation, thus causing the observed abnormalities; the endogenous theory holds that this is a syndrome of vascular origin and that the bands have no causative role. Prognosis depends on the severity of malformations. We here report two cases of lethal malformations in order to discuss the challenges in the diagnosis and treatment of amniotic band syndrome. This study mainly aims to highlight the role of prenatal diagnosis in the therapeutic management of this embryo-fetopathy. [ABSTRACT FROM AUTHOR]

Meckel Gruber syndrome is a rare autosomal recessive polymalformation syndrome characterized by occipital encephalocele, polydactyly and cystic renal dysplasia. Ultrasound is, at present, the best tool for prenatal screening of this lethal polymalformation and diagnosys is confirmed by karyotyping. We here report a case of Meckel Gruber syndrome detected by ultrasound. Abortion was performed at 25 weeks of amenorrhoea. [ABSTRACT FROM AUTHOR]

Résumé Objectif Évaluer le bilan d’imagerie (échographie ± IRM) dans le diagnostic des malformations lymphatiques kystiques de localisations cervicales. Méthodes Étude rétrospective, descriptive des patientes ayant bénéficié d’un dépistage échographique de masses cervicales antérieures, confirmées en échographie de référence, au Centre pluridisciplinaire de diagnostic prénatal du Centre hospitalier régional universitaire de Lille de 1997 à 2014. Résultats Dix-sept lymphangiomes ont été recensés. Douze (71 %) lymphangiomes étaient diagnostiqués lors de l’échographie de référence et 88 % lors de l’IRM. On retrouvait une extension de la masse pour 10 (62 %) lymphangiomes en échographie et pour 11 (85 %) en IRM. Dans la plupart des cas, on objectivait respectivement en échographie et en IRM : une extension de la face (4, 23 %/6, 46 %), de la base de la langue (3, 18 %/2, 15 %) et du plancher buccal (3, 18 %/3, 15 %). Une atteinte pharyngée (5,38 %) et mandibulaire (4,31 %) était dépistée en IRM et non retrouvée en échographie. Deux (12 %) fœtus étaient porteurs de malformation urogénitale, 1 (6 %) de malformation cardiaque et 1 (6 %) de malformation faciale associée en échographie. Les lymphangiomes restaient stables dans 12 (71 %) des cas et disparaissaient dans 2 (12 %) des cas avant la naissance. Conclusion L’IRM et l’échographie paraissent indissociables pour permettre une évaluation et une prise en charge optimale des masses cervicales. Le bilan des lésions associées semble pouvoir nous aider dans l’orientation diagnostique. Enfin, les lymphangiomes semblent avoir une stabilité au cours de la grossesse et un bon pronostic en cas de masse cervicale lymphatique non compliquée et sans extension péjorative. Objectives Assess imaging (ultrasound ± MRI) in the diagnosis of cervical cystic lymphangioma. Methods Retrospective, descriptive study of the patients who underwent reference ultrasound screening for fetal anterior cervival masses in multidisciplinary prenatal diagnosis center of the Lille Regional University Hospital from 1997 to 2014. Results Seventeen lymphangiomas were identified. Seventy-three percent of lymphangiomas ( n = 12) were diagnosed in the baseline ultrasound and 85% ( n = 11) in MRI. An extra-cervical extension was identified in 10 (62%) with ultrasound and 11 (85%) with MRI. Main sites of mass extension objectived by ultrasound and MRI were respectively the face (4,23%/6,46%), the base of tongue (3, 18%/2, 15%) and buccal floor (3, 18%/3, 15%). Pharyngeal disease (5,38%) and mandible (4,31%) were detected by MRI and not found on ultrasound. Associated malformations detected with ultrasound were 2 (12%) urogenital malformation, 1 (6%) heart defect and 1 (6%) facial anomalies. Lymphangiomas remained stable in volume in 12 (71%) cases and disappeared before birth in 2 (12%) cases. Conclusion MRI and ultrasound seem inseparable to assess and optimally manage fetal cervical masses. Detection of associated lesions seems to help in the final lymphangioma diagnosis. Most of the time, lymphangiomas seem to be stable lesion during pregnancy and a good prognosis in cases of uncomplicated cervical lymphatic mass and without pejorative extension. [ABSTRACT FROM AUTHOR]

The authors report four observations of multiple pregnancies where one of the foetuses was affected by a lethal malformation. The mothers preferred palliative care after birth rather than selective termination of pregnancy (moreover impossible in one case). Three mothers were primiparous and one was multiparous. The delivery occurred by caesarian section at 30, 32, 33 and 37 weeks of gestational age. Four malformed children died after meeting with their parents at 8 minutes, 1 hour and a half, 2 hours, 4 hours after birth. This practice, which is sometimes proposed to the parents in our department, by avoiding any dangerous procedure during the prenatal period, allows parents to meet with the child, and therefore permits emergency bonding between mother and child. It thus may be a strengthening of the parenthood and attachment favoring later mourning. The limits of the perinatal palliative approach are a too big uncertainty on the nature of the malformations and the potential postnatal life expectancy, as well as the fear that the child suffers at birth and later. [ABSTRACT FROM AUTHOR]